The mission of Prognosis is to explore the nexus at which healthcare policy meets healthcare practice and how one affects the other. This blog makes readers more aware of the innovations taking place in healthcare delivery, financing and technology and the types of public policies that will encourage further progress.

Healthcare In Focus is a public education initiative of the HLC, created to promote a constructive dialogue about the state and future of American healthcare.

On the eve of the White House’s bipartisan health reform summit, the Healthcare Leadership Council has signed onto a full page ad, initiated by the Mayo Clinic, in Roll Call, the Capitol Hill newspaper. The ad calls for health reforms “that provide quality, affordable health care for all Americans.” Other signers include HLC members Aetna, Cleveland Clinic and Marshfield Clinic as well as the U.S. Chamber of Commerce, America’s Health Insurance Plans and high-profile health providers from across the country.

Specifically, those of us who signed the ad are emphasizing that there must be two core elements to any health reform measure that becomes law, specifically:

• Create a cost-effective Medicare payment system by establishing incentives for doctors and hospitals to offer the highest quality care at the most reasonable cost. This will reduce unnecessary procedures and ensure Medicare is viable for future generations.

Many of us have argued for some time now that health reform is indeed achievable if Congress will agree to strip away the political and ideological excesses that lead inevitably to partisan gridlock, and focus on these vital elements – give people of modest means the ability to gain access to the system through private insurance, and then improve the system so that we’re paying for quality instead of simply volume of services.

We’ve signed onto the ad in Roll Call because we believe it’s not too late to get this done.

Yes, there’s a lot of understandable frustration in Washington, DC these days, and not just because of the horrendous post-blizzard rush hour traffic. There’s a sense of desperation in the air as the November elections draw ever nearer and health reform legislation remains stuck short of the finish line.

With the clock running, it’s more than a little dispiriting to see that some politicians and interest groups, instead of trying to craft a middle-ground solution that can gain strong popular and political support, are turning to an old chestnut of a strategy.

Let’s beat up on the insurance companies.

As we head toward next week’s bipartisan White House summit on health reform, a loud refrain is being heard right now. We need to pass health reform in order to protect Americans from the big, bad insurers. The linchpin for this chorus is the premium rate increase that Anthem Blue Cross proposed in California. Read more

One of the oft-cited goals of health reform is to ‘bend the cost curve’ on health spending. On that point, a recent op-ed in the Wall Street Journal raises questions over whether the current House and Senate bills could actually exacerbate costs as a result of new health-related litigation.

Where might these lawsuits arise? Writing in the Journal, Curt Levey, the executive director of the Committee for Justice, points toward the legislation’s creation of “new federally enforceable rights and obligations, layers of complex federal regulations, and dozens of new programs and agencies — not to mention 50 brand-new health ‘exchanges’.” Legal action would contest everything from questions of constitutionality to procedural disputes to individual coverage challenges to contests of bureaucratic decisions implementing the legislation.

Levey emphasizes that “there’s enough vague and ambiguous statutory language to keep lawyers employed for decades.” For instance, some provisions that call for HHS’s broad rule-making could end up being litigated “as an improper delegation of congressional authority.” But the number of lawsuits would especially mount from individuals’ case-by-case disputes. People would exercise their “new-found right to essential health benefits.” Legally challenging limitless, routine coverage decisions could well spring forth in droves. Read more

Expectant and new mothers now have access to a tool to help keep themselves and their babies healthy – free informational tips sent to their cell phones.

Recently, the National Healthy Mothers, Healthy Babies Coalition (HMHB) launched Text4baby, a free mobile information service designed to promote maternal and child health. Text4baby provides pregnant women and new moms with information they need to take care of their health and give their babies the best possible start in life. Women who sign up for the service by texting BABY (or BEBE for Spanish) to 511411 will receive free SMS text messages each week, timed to their due date or baby’s date of birth. Since the launch, over 10,000 women from all 50 states have been registered for the program.

According to its sponsors, the text4baby campaign is the first free, health education program in the U.S. to utilize mobile phones. Among the sponsors are three Healthcare Leadership Council members: Johnson & Johnson, Pfizer, and WellPoint.

I would like to commend these three organizations for taking part in such an innovative health outreach program.

I applaud President Obama’s good intentions in seeking to host a bipartisan health reform summit on February 25, bringing together congressional Democrats and Republicans to put ideas on the table and find a way to move the reform process forward. Of course, substantive agreements won’t be reached in a half-day meeting, but it’s still a step in a much-needed positive direction.

But are we moving toward bipartisanship? Politico reported on Tuesday that a House leadership aide, in a speech to a national health policy conference, said that a path has been developed to move the current House and Senate bills through Congress and onto the President’s desk. In essence, the House would pass the Senate health reform bill, and then a package of changes to the Senate bill would pass both houses. In the Senate, this would require using the controversial budget reconciliation process and evading the conventional 60-vote threshold necessary for most major bills. Under reconciliation, Senate Democrats could push the health reform revisions through with just 51 votes, over the objection of Republicans and moderate Democrats. Read more